RN Case Manager Job at North Shore Medical Center in Miami

WE ARE NORTH SHORE MEDICAL CENTER

Our primary function is to offer continuous nursing, medical, and other health and social services on a 24-hour basis, under physician directed care and RN supervision.

We service a multitude of patients and their families across our vast network, while remaining committed to the professional development of our staff, the functional improvement of our patients, and the cultivation of strong partnerships within our communities.

WHAT WE OFFER

• Essential/stable and growing company with many opportunities for training and advancement within the medical field that all employees and team members (including Full-Time and Part-Time) can benefit from.
• Hourly pay is negotiable based on experience. We offer competitive market pay and opportunities for bonus depending on great work performance (bonuses only apply for Full Time).
• Comprehensive Employee Benefits: Full-Time employees are eligible for various plans for medical, dental, and vision insurance.

JOB DUTIES/RESPONSIBILITIES

The Case Manager RN is a member of an interdisciplinary health care team, and is responsible for assessing patient care needs and monitoring utilization of resources to ensure timely and appropriate payment from third parties. Coordinates multidisciplinary care, ensuring continuity of services, from entry to discharge. Monitors and acts on variances from safety, quality and clinical standards.

DUTIES AND RESPONSIBILITIES

• Reviews and ensures appropriate utlization of resources, alerting physicians regarding cases not meeting admission criteria, with questionable medical management, or with documentation problems.
• Facilitates the plan of care through the continuum from entry to discharge, collaborating with others, and managing various health interventions. Identifies needs of medical and psycho-social high risk and resource intensive patients. Works with Case Management staff as needed to expedite discharge.
• Captures, documents and maintains current information dealing with hospital standards, the plan of care, progress and information substaining the need for continued stay, either manually or via computer in appropriate areas of medical record.
• Identifies and acts on variances from standards of care. Assists team with identifying and resolving quality problems related to scheduling, duplicate ordering of tests/services, and significant variances from care paths. Contacts attending physician regarding UR, Resource Management and QI issues.
• Provides clinical leadership, expertise and support. Has knowledge of community resources and accesses them for customers.
• Reviews pertinent literature and attends seminars/workshops as available to remain current in the field. Completes annual recertification within established time frames, attends departmental inservices and maintains licensure/certification as appropriate.
• Provides excellent service to all customers, striving to exceed expectations. Shows concern, compassion, and respect for patients and families. Maintains positive and professional relationships with hospital healthcare team members, outside health providers, and community agencies.
• Performs other duties as assigned.

EDUCATION AND TRAINING:

• Graduate of a School of Nursing required
• BSN preferred

LICENSING/REGISTRATION/CERTIFICATION:

Licensed as an RN in the State of Florida.

EXPERIENCE:

Previous medical or psychiatric experience preferred.

SKILLS AND ABILITIES:

• Knowledge of applicable clinical populations.
• Knowledge of health care continuum.
• Knowledge of and skill in accessing community resources.
• Familiarity with medical terminology and discharge planning.
• General knowledge of DRG, APC, CPT, and ICD-9CM coding.
• Basic understanding of statistical and quality irmprovement techniques and reports.
• Knowledge of treatment protocols, standards and guidelines.
• Knowledge of resources and case management.
• Working knowledge of health care finance and third party payment methods.
• Ability to work independently, as part of a team, and with others from diverse backgrounds.
• Developed negotiation skills.
• Effective communication skills.
• Experience with PC, mainframe or Internet based information system.
• Working knowledge of a personal computer and basic software packages.